One hundred sixty-seven thumb replantations and revascularisations: early microvascular results

Abstract

One hundred sixty-seven thumb replantations and revascularisations were performed from 1977 to 1987 by the Ljubljana microsurgical team. Early microvascular results of thumb replantations and early reoperations were analysed retrospectively. Age of the patients, level of traumatic amputation, mechanism of injury, use of arterial grafts, severity (total-subtotal) of amputation and occurrence of thrombosis were potential survival factors analysed with logistic regression analysis. The overall success rate for this series was 66% (72% for failures to revascularise excluded). The most frequent cause of failure was venous thrombosis. The most critical time for failure was the first 4 days after the replantation. No microvascular complication occurred later than the seventh day and no reoperation was successful later than the third day after replantation. Survival factors were studied with logistic regression analysis which showed that the model was not statistically significant. However, estimation of relative risks gave us useful but statistically uncertain information regarding the survival factors inspected.